Schizophrenia is one of the disorders that most interferes with the quality of life of people who suffer from it. For this reason, it is very important to know their different presentations and the most effective treatments for them.
Currently, the classification of the different types of schizophrenia has been discarded. However, there are numerous clinicians who point out that it is of special interest to know the characteristics of the different classifications of schizophrenia for the correct treatment of the patient. The different forms of schizophrenia that occur are paranoid type, hebephrenia, undifferentiated type, residual and catatonic.
In this Psychology-Online article, we will help you understand hebephrenic schizophrenia, one of the subtypes of schizophrenic disorder. If you want to know more about this, keep reading this article: hebephrenic schizophrenia: causes, symptoms and treatment.
Definition of hebephrenic schizophrenia
Hebephrenic schizophrenia is also known as disorganized schizophrenia and is mainly characterized by a marked disturbance of speech and behavior, with a flat and inappropriate presentation of affect.
The term hebephrenia was introduced in 1871 by the psychiatrist E. Hecker, later changing the name from hebephrenic schizophrenia to disorganized schizophrenia. Hebephrenia is understood as a morbid process, which, beginning at the time of puberty, leads through slow development, although sometimes somewhat faster, to a state of mental weakness. The essence of the condition does not change, whether the morbid process evolves in the simplest form as a progressive and silent deterioration, or whether it evolves in a more lively way, accompanied by depressive symptoms, excitement, temporary delusional ideation, etc. .
Causes of hebephrenic or disorganized schizophrenia
Currently, the causes of disorganized schizophrenia are unknown. Despite this, it is known that it has an early onset, that is, it appears between 15 and 25 years of age and an insidious onset; generally, the onset of the disease evolves slowly, with a continuous course and without significant remissions. Usually, this subtype of schizophrenia is also associated with a premorbid, impoverished personality and there is a strong genetic componentthe development of this mental disorder being more likely if the person has a family history of depression or psychosis.
Symptoms of hebephrenic or disorganized schizophrenia
According to the DSM-IV, the main characteristics of hebephrenic schizophrenia are Disorganized language and behavior and flattened or inappropriate affectivity. The presence of delusions and hallucinations are fragmented and not organized around a coherent theme and are not the predominant symptoms of the disorder, indicating that the positive symptoms of schizophrenia are not the most representative of said disorder. The signs and symptoms of hebephrenic or disorganized schizophrenia are as follows:
- Early start. The early onset of hebephrenic schizophrenia was considered one of the most representative aspects of this subtype of schizophrenia. For this reason, this subtype was called hebephrenic, since the etiology of the word hebephrenia comes from the Greek (“Hébé”) which means “young, youth.”
- Disorganized language. Language is one of the most affected components in hebephrenic schizophrenia. There is a marked alteration in the production of oral language, with disorganization of speech, frequent blockages, loss of the guiding thread and associative capacity, change of topic spontaneously and with affectation of the semantics and organization of the language, giving lead to significant cognitive deficits. These language limitations sometimes cause a tendency toward social avoidance, in an attempt to reduce environmental stimulation.
- Behavioral disorganization. Behavioral disorganization refers to the difficulty of orienting oneself towards a goal, which can lead to a disruption in the ability to carry out activities of daily living, such as showering, dressing, preparing food… In addition to this, incongruent behavior or associated characteristics including grimacing, mannerisms, and other behavioral oddities such as socially inappropriate behaviors.
- Flattened or inappropriate affectivity. The affective alterations that occur in hebephrenic schizophrenia are the same limitations found in schizophrenic disorder. An affective flattening occurs, giving rise to no reaction to emotional stimuli, resulting in a reduction in the intensity of emotional expression or expressing incoherent emotions regarding the context. On the other hand, they reduce the ability to persist or start an activity, limit the lack of willpower and make it difficult for the person to feel pleasure with the activities that they used to feel.
The set of signs and symptoms of hebephrenic schizophrenia give rise to a predominance of negative symptoms. Faced with this symptomatology, a worse prognosis is established, due to the rapid appearance of symptoms, which cause a considerable increase in behavioral, cognitive and emotional deficits. In addition, it should be noted that negative symptoms respond worse to antipsychotic medications than positive symptoms.
Treatment for hebephrenic or disorganized schizophrenia
Any subtype of schizophrenia, in this case specifically, hebephrenic schizophrenia, requires long-term treatment, in many cases for life, even if there is no presentation of symptoms. The most important thing in the treatment is to be able to execute a multi-disciplinary intervention with the different disciplines in mental health: psychiatry, psychology, social work, nursing,…
First, a complete evaluation must be performed for . In general, the treatment of hebephrenic schizophrenia tends to begin in the psychiatric discipline, with the administration of antipsychotics, in order to control signs and symptoms effectively, using the lowest possible dose. The use of antidepressant and anxiolytic drugs is also common. The stabilization of symptoms makes it possible to carry out psychosocial therapy.
In some cases, hospitalization is required, during periods of crisis or severe symptoms. Hospitalization has the objective of guaranteeing the safety of the person, since due to their limitations it is possible that they neglect basic needs habits, such as good nutrition, sleep rhythm or hygiene. Another possible difficulty is that the patient does not respond adequately to the medications administered, in which case a possible alternative is electroconvulsive therapy, also useful in depression.
Given the stabilization of symptoms, it is appropriate to start a psychosocial intervention. However, the start of the intervention does not imply the suppression of drug administration. The most common treatments for hebephrenic schizophrenia are the following:
- Individual therapy: Individual therapy has the objective of helping the patient identify the symptoms, with the aim of establishing strategies against possible relapses and thus being able to control the disease. On the other hand, it offers tools to help and work on the normalization of thought patterns.
- Social skills training: In hebephrenic schizophrenia, working on social skills is very important, due to the strong impact of negative symptoms. Faced with this, the work focuses on improving communication, social interactions, the identification of emotions and their contextualization.
- Family therapy: as previously detailed, negative symptoms can cause a strong impact on the environment, since the patient reacts with an avoidant component. This factor can harm the family unit, so it is important to provide support and information to families in the face of this disorder. In addition to this set of interventions, many people who suffer from this disorder require daily help. To achieve this, there are different associations that provide the necessary support for these people, helping them find and keep a job, housing, crisis situations, and self-help groups.
This article is merely informative, at Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
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Bibliography
- AMERICAN PSYCHIATRIC ASSOCIATION (APA). (2002). Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. Barcelona: Masson.
- Accatino, L. (2012). Language disorders in Schizophrenia. Rev. Memoriza, 9, 1-8.
- Hoche, A. (2009). The schizophrenic process. hebephrenic form. Neuropsychiatric Clinic, 15, 14.
- Martín, F., et at. (2008). Intellectual and cognitive impairment: reflections on a case of disorganized schizophrenia. Square Neuropsychol, 2, 8.